| NPI | 1952792657 |
|---|---|
| Former Name | AMALIE CATHERINE THAVIKULWAT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MA 274715) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.071334) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2022-01-19 |